Potential adverse cardiovascular effects from excessive endurance exercise

Mayo Clinic Proceedings

Volumn 87, Issue 6, 2012, Pages 587-595

  O'Keefe, James H ^a   Patil, Harshal R ^a   Lavie, Carl J ^b,c   Magalski, Anthony ^a   Vogel, Robert A ^d   McCullough, Peter A ^e  

^a SAINT LUKE S MID AMERICA HEART INSTITUTE   (United States)

^b UNIVERSITY OF QUEENSLAND   (Australia)

^c PENNINGTON BIOMEDICAL RESEARCH CENTER   (United States)

^d UNIVERSITY OF MARYLAND   (United States)

^e St John Providence Health System   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

BIOLOGICAL MARKER; BRAIN NATRIURETIC PEPTIDE; TROPONIN;

ARTERIAL STIFFNESS; ATHLETE; CARDIOVASCULAR EFFECT; CONFERENCE PAPER; CORONARY ARTERY CALCIFICATION; DIASTOLIC DYSFUNCTION; ENDURANCE TRAINING; EXERCISE INTENSITY; HEART ATRIUM ARRHYTHMIA; HEART ATRIUM FIBRILLATION; HEART MUSCLE FIBROSIS; HEART MUSCLE INJURY; HEART RIGHT VENTRICLE EJECTION FRACTION; HEART VENTRICLE ARRHYTHMIA; HUMAN; NONHUMAN; PATHOPHYSIOLOGY; PREVALENCE; RISK ASSESSMENT; RISK BENEFIT ANALYSIS; RISK FACTOR; SUDDEN DEATH;

EID: 84863481830     PISSN: 00256196     EISSN: None     Source Type: Journal    
DOI: 10.1016/j.mayocp.2012.04.005     Document Type: Conference Paper

References (68)

1. Haskell WL, Lee IM, Pate RR, et al. Physical activity and public health: Updated recommendation for adults from the American College of Sports Medicine and the American Heart Association. Circulation. 2007;116(9):1081-1093. (Pubitemid 47329572)
2. Sarna S, Sahi T, Koskenvuo M, Kaprio J. Increased life expectancy of world class male athletes. Med Sci Sports Exerc. 1993; 25(2):237-244. (Pubitemid 23061986)
3. Chakravarty EF, Hubert HB, Lingala VB, Fries JF. Reduced disability and mortality among aging runners: A 21-year longitudinal study. Arch Intern Med. 2008;168(15):1638-1646.
4. Lavie CJ, Thomas RJ, Squires RW, Allison TG, Milani RV. Exercise training and cardiac rehabilitation in primary and secondary prevention of coronary heart disease. Mayo Clin Proc. 2009;84(4):373-383.
5. Wen CP, Wai JP, Tsai MK, et al. Minimum amount of physical activity for reduced mortality and extended life expectancy: A prospective cohort study. Lancet. 2011;378(9798):1244-1253.
6. O'Keefe JH, Patil HR, Lavie CJ. Exercise and life expectancy. Lancet. 2012;379(9818):799; author reply 800-801.
7. Lee J, Patte R, Lavie CJ, Blair SN. Running and all-cause mortality risk: Is more better? Med Sci Sports Exerc. 2012;44(6):990-994.
8. Michaelides AP, Soulis D, Antoniades C, et al. Exercise duration as a determinant of vascular function and antioxidant balance in patients with coronary artery disease. Heart. 2011; 97(10):832-837.
9. Sharma S, Zaidi A. Exercise-induced arrhythmogenic right ventricular cardiomyopathy: Fact or fallacy? Eur Heart J. 2012;33(8): 938-940.
10. USA Marathoning: 2007 Overview. MarathonGuide.com Web site. http://www.marathonguide.com/features/Articles/2007 RecapOverview.cfm. Accessed January 23, 2012.
11. Redelmeier DA, Greenwald JA. Competing risks of mortality with marathons: Retrospective analysis. BMJ. 2007;335(7633): 1275-1277.
12. Kim JH, Malhotra R, Chiampas G, et al. Cardiac arrest during long-distance running races. N Engl J Med. 2012;366(2):130-140.
13. Sheppard MN. The fittest person in the morgue? Histopathology. 2012;60(3):381-396.
14. Harris KM, Henry JT, Rohman E, Haas TS, Maron BJ. Sudden death during the triathlon. JAMA. 2010;303(13):1255-1257.
15. Harmon KG, Asif IM, Klossner D, Drezner JA. Incidence of sudden cardiac death in National Collegiate Athletic Association athletes. Circulation. 2011;123(15):1594-1600.
16. Albano AJ, Thompson PD, Kapur NK. Acute coronary thrombosis in Boston marathon runners. N Engl J Med. 2012;366(2): 184-185.
17. Maron BJ, Pelliccia A, Spirito P. Cardiac disease in young trained athletes: Insights into methods for distinguishing athlete's heart from structural heart disease, with particular emphasis on hypertrophic cardiomyopathy. Circulation. 1995; 91(5):1596-1601.
18. Pluim BM, Zwinderman AH, van der Laarse A, van der Wall EE. The athlete's heart: A meta-analysis of cardiac structure and function. Circulation. 2000;101(3):336-344. (Pubitemid 30054163)
19. Maron BJ, Pelliccia A. The heart of trained athletes: Cardiac remodeling and the risks of sports, including sudden death. Circulation. 2006;114(15):1633-1644. (Pubitemid 44547434)
20. Spirito P, Pelliccia A, Proschan MA, et al. Morphology of the "athlete's heart" assessed by echocardiography in 947 elite athletes representing 27 sports. Am J Cardiol. 1994;74(8):802-806. (Pubitemid 24312975)
21. Pelliccia A, Culasso F, Di Paolo FM, Maron BJ. Physiologic left ventricular cavity dilatation in elite athletes. Ann Intern Med. 1999;130(1):23-31. (Pubitemid 29019445)
22. Pelliccia A, Maron BJ, Di Paolo FM, et al. Prevalence and clinical significance of left atrial remodeling in competitive athletes. J Am Coll Cardiol. 2005;46(4):690-696. (Pubitemid 41132699)
23. Pelliccia A, Maron BJ, Spataro A, Proschan MA, Spirito P. The upper limit of physiologic cardiac hypertrophy in highly trained elite athletes. N Engl J Med. 1991;324(5):295-301.
24. Benito B, Gay-Jordi G, Serrano-Mollar A, et al. Cardiac arrhythmogenic remodeling in a rat model of long-term intensive exercise training. Circulation. 2011;123(1):13-22.
25. Praphatsorna P, Thong-Ngama D, Kulaputanaa O, Klaikaewb N. Effects of intense exercise on biochemical and histological changes in rat liver and pancreas. Asian Biomedicine. 2010;4(4): 619-625.
26. Middleton N, Shave R, George K, et al. Altered left ventricular diastolic filling following a marathon is a reproducible phenomenon. Int J Cardiol. 2007;122(1):87-89. (Pubitemid 47516601)
27. Patel DA, Lavie CJ, Milani RV, Ventura HO. Left atrial volume index predictive of mortality independent of left ventricular geometry in a large clinical cohort with preserved ejection fraction. Mayo Clin Proc. 2011;86(8):730-737.
28. Maron BJ. Hypertrophic cardiomyopathy and other causes of sudden cardiac death in young competitive athletes, with considerations for preparticipation screening and criteria for disqualification. Cardiol Clin. 2007;25(3):399-414, vi. (Pubitemid 47603215)
29. Ector J, Ganame J, van der Merwe N, et al. Reduced right ventricular ejection fraction in endurance athletes presenting with ventricular arrhythmias: A quantitative angiographic assessment. Eur Heart J. 2007;28(3):345-353.
30. Mohlenkamp S, Lehmann N, Breuckmann F, et al. Running: The risk of coronary events; prevalence and prognostic relevance of coronary atherosclerosis in marathon runners. Eur Heart J. 2008;29(15):1903-1910.
31. Breuckmann F, Mohlenkamp S, Nassenstein K, et al. Myocardial late gadolinium enhancement: Prevalence, pattern, and prognostic relevance in marathon runners. Radiology. 2009; 251(1):50-57.
32. Trivax JE, Franklin BA, Goldstein JA, et al. Acute cardiac effects of marathon running. J Appl Physiol. 2010;108(5):1148-1153.
33. Pelliccia A, Maron BJ, De Luca R, Di Paolo FM, Spataro A, Culasso F. Remodeling of left ventricular hypertrophy in elite athletes after long-term deconditioning. Circulation. 2002; 105(8):944-949. (Pubitemid 34184572)
34. Seifi-Skishahr F, Siahkohian M, Nakhostin-Roohi B. Influence of aerobic exercise at high and moderate intensities on lipid peroxidation in untrained men. J Sports Med Phys Fitness. 2008;48(4):515-521.
35. O'Keefe JH, Vogel R, Lavie CJ, Cordain L. Achieving huntergatherer fitness in the 21(st) century: Back to the future. Am J Med. 2010;123(12):1082-1086.
36. O'Keefe JH, Vogel R, Lavie CJ, Cordain L. Exercise like a hunter-gatherer: A prescription for organic physical fitness. Prog Cardiovasc Dis. 2011;53(6):471-479.
37. Neilan TG, Januzzi JL, Lee-Lewandrowski E, et al. Myocardial injury and ventricular dysfunction related to training levels among nonelite participants in the Boston marathon. Circulation. 2006;114(22):2325-2333. (Pubitemid 44847449)
38. Shave R, Baggish A, George K, et al. Exercise-induced cardiac troponin elevation: Evidence, mechanisms, and implications. J Am Coll Cardiol. 2010;56(3):169-176.
39. Neumayr G, Gaenzer H, Pfister R, et al. Plasma levels of cardiac troponin I after prolonged strenuous endurance exercise. Am J Cardiol. 2001;87(3):369-371, A310. (Pubitemid 32144890)
40. Scherr J, Braun S, Schuster T, et al. 72-h kinetics of highsensitive troponin T and inflammatory markers after marathon. Med Sci Sports Exerc. 2011;43(10):1819-1827.
41. McCullough PA, Chinnaiyan KM, Gallagher MJ, et al. Changes in renal markers and acute kidney injury after marathon running. Nephrology. 2011;16(2):194-199.
42. La Gerche A, Robberecht C, Kuiperi C, et al. Lower than expected desmosomal gene mutation prevalence in endurance athletes with complex ventricular arrhythmias of right ventricular origin. Heart. 2010;96(16):1268- 1274.
43. Harper RW. Exercise-induced troponin elevation: Not necessarily a benign phenomenon. J Am Coll Cardiol. 2010;56(25): 2145; author reply 2145-2146.
44. Nassenstein K, Breuckmann F, Lehmann N, et al. Left ventricular volumes and mass in marathon runners and their association with cardiovascular risk factors. Int J Cardiovasc Imaging. 2009;25(1):71-79.
45. La Gerche A, Burns AT, Mooney DJ, et al. Exercise-induced right ventricular dysfunction and structural remodelling in endurance athletes. Eur Heart J. 2012;33(8):995-1006.
46. Heidbuchel H, Hoogsteen J, Fagard R, et al. High prevalence of right ventricular involvement in endurance athletes with ventricular arrhythmias: Role of an electrophysiologic study in risk stratification. Eur Heart J. 2003;24(16):1473-1480. (Pubitemid 37010576)
47. Agabiti-Rosei E, Mancia G, O'Rourke MF, et al. Central blood pressure measurements and antihypertensive therapy: A consensus document. Hypertension. 2007;50(1):154-160. (Pubitemid 46986036)
48. Laurent S, Cockcroft J, Van Bortel L, et al. Expert consensus document on arterial stiffness: Methodological issues and clinical applications. Eur Heart J. 2006;27(21):2588-2605. (Pubitemid 44627304)
49. Vlachopoulos C, Kardara D, Anastasakis A, et al. Arterial stiffness and wave reflections in marathon runners. Am J Hypertens. 2010;23(9):974-979.
50. Wilson M, O'Hanlon R, Prasad S, et al. Diverse patterns of myocardial fibrosis in lifelong, veteran endurance athletes. J Appl Physiol. 2011;110(6):1622-1626.
51. Oxborough D, Birch K, Shave R, George K. "Exercise-induced cardiac fatigue": A review of the echocardiographic literature. Echocardiography. 2010;27(9):1130-1140.
52. Haskell WL, Sims C, Myll J, Bortz WM, St Goar FG, Alderman EL. Coronary artery size and dilating capacity in ultradistance runners. Circulation. 1993;87(4):1076-1082. (Pubitemid 23110378)
53. Schwartz J, Merkel-Kraus S, Duval S. Does elite athleticism enhance or inhibit coronary artery plaque formation? Paper presented at: American College of Cardiology 2010 Scientific Sessions; March 16, 2010; Atlanta, GA.
54. Goel R, Majeed F, Vogel R, et al. Exercise-induced hypertension, endothelial dysfunction, and coronary artery disease in a marathon runner. Am J Cardiol. 2007;99(5):743-744.
55. Vlachopoulos C, Aznaouridis K, Stefanadis C. Prediction of cardiovascular events and all-cause mortality with arterial stiffness: A systematic review and meta-analysis. J Am Coll Cardiol. 2010;55(13):1318-1327.
56. Mont L, Elosua R, Brugada J. Endurance sport practice as a risk factor for atrial fibrillation and atrial flutter. Europace. 2009; 11(1):11-17.
57. Westrol MS, Kapitanyan R, Marques-Baptista A, Merlin MA. Causes of sudden cardiac arrest in young athletes. Postgrad Med. 2010;122(4):144-157.
58. Rector RS, Rogers R, Ruebel M, Hinton PS. Participation in road cycling vs running is associated with lower bone mineral density in men. Metabolism. 2008;57(2):226-232.
59. Mont L, Sambola A, Brugada J, et al. Long-lasting sport practice and lone atrial fibrillation. Eur Heart J. 2002;23(6):477-482. (Pubitemid 35204187)
60. Elosua R, Arquer A, Mont L, et al. Sport practice and the risk of lone atrial fibrillation: A case-control study [published correction appears in Int J Cardiol. 2007;123(1):74]. Int J Cardiol. 2006;108(3):332-337. (Pubitemid 43339799)
61. Molina L, Mont L, Marrugat J, et al. Long-term endurance sport practice increases the incidence of lone atrial fibrillation in men: A follow-up study. Europace. 2008;10(5):618-623. (Pubitemid 351775294)
62. Mont L, Tamborero D, Elosua R, et al. Physical activity, height, and left atrial size are independent risk factors for lone atrial fibrillation in middle-aged healthy individuals. Europace. 2008; 10(1):15-20. (Pubitemid 351767264)
63. Aizer A, Gaziano JM, Cook NR, Manson JE, Buring JE, Albert CM. Relation of vigorous exercise to risk of atrial fibrillation. Am J Cardiol. 2009;103(11):1572-1577.
64. Kirchhof P, Lip GY, Van Gelder IC, et al. Comprehensive risk reduction in patients with atrial fibrillation: Emerging diagnostic and therapeutic options-a report from the 3rd Atrial Fibrillation Competence NETwork/European Heart Rhythm Association consensus conference. Europace. 2012;14(1):8-27.
65. Biffi A, Pelliccia A, Verdile L, et al. Long-term clinical significance of frequent and complex ventricular tachyarrhythmias in trained athletes. J Am Coll Cardiol. 2002;40(3):446-452. (Pubitemid 34833158)
66. Burstein B, Nattel S. Atrial fibrosis: Mechanisms and clinical relevance in atrial fibrillation. J Am Coll Cardiol. 2008;51(8):802-809. (Pubitemid 351260071)
67. Wilson JN, Markey CN, Markey PM. Fitness correlates of obligatory versus health motives for exercise: An examination of men in the military. Psychol Sport Exer. 2012;13(4):371-377.
68. Griffiths MD, Szabo A, Terry A. The exercise addiction inventory: A quick and easy screening tool for health practitioners. Br J Sports Med. 2005;39(6):e30.